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CHAPTER ONE
A Public Health
Emergency
Since the mid-1990s, when the fi rst major study of childhood
trauma was published, scientists have compiled a vast amount of
research on the topic. This has broadened scientifi c understand-
ing of its causes, its effects on children and adolescents, and its
prevalence, including the regions of the United States where it is
most prevalent. Although much remains unknown, scientists and
health offi cials widely agree that childhood trauma is one of soci-
ety’s most urgent problems.
One report that highlighted this urgency was released in Feb-
ruary 2018 by Child Trends, an organization that conducts re-
search on improving children’s lives. Using a comprehensive anal-
ysis of data from a national children’s health survey, researchers
found that nearly half of children and youth in the United States
have experienced at least one ACE, and many experienced more
than one. “There’s an increasing awareness that these experienc-
es are a really important public-health issue,” says Child Trends
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research scientist Vanessa Sacks.
The Many Causes of Trauma
Although children can be, and are, subjected to a disturbing vari-
ety of traumatic experiences, such experiences have proved to be
much more common than others. According to the Child Trends
report, the most prevalent ACE, affecting an average of 25.5 per-
cent of children, is living in a family that does not have enough
income to pay for basic expenses like food and housing. That ACE
is closely followed by divorce of parents or guardians, which affects
about 25 percent of children.
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